Diffuse pigmented villonodular synovitis treated with arthroscopic total synovial peel.

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Oncology
• Arthroscopy

Background:

• Diffuse pigmented villonodular synovitis (PVNS) frequently recurs after surgical treatment.
• Achieving a complete and long-term cure for PVNS remains challenging.

Purpose of the Study:

• To introduce and evaluate the efficacy of arthroscopic total synovial peel (ATSP) for diffuse PVNS.
• To reduce the postoperative recurrence rate of diffuse PVNS.

Main Methods:

• Nineteen patients with diffuse PVNS of the knee underwent ATSP between March 2014 and July 2020.
• The ATSP technique involves a 'peeling' of the synovium, distinct from simple excision.
• Outcomes were assessed via imaging, recurrence rates, and functional scores (VAS, TLS) with a mean follow-up of 36 months.

Main Results:

• The study reported a recurrence rate of 10.5% following ATSP.
• Patients without recurrence showed significant improvements: VAS decreased from 4.76 to 1.56, and TLS increased from 67.76 to 90.32.
• ATSP demonstrated a significantly lower postoperative recurrence rate compared to existing literature.

Conclusions:

• Arthroscopic total synovial peel (ATSP) is a potentially effective arthroscopic treatment for diffuse PVNS.
• This technique shows promise in substantially reducing the recurrence of PVNS.
• ATSP warrants consideration as a viable clinical option for managing diffuse PVNS.